Aeromedical Decision Making Flashcards

1
Q

What are the component of aeromedical decision making

A

1- Member/applicant - an open and honest declaration of any significant health issues
2 - Regulator - to assess this information and make a decision that is transparent reasonable and consistent
3- AVMO/DAME - to conduct a competent medical examination (in all its facets)

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2
Q

What makes a good decision

A

1 - Consistent - replicable

  • with other decisions under comparable circumstances
  • with other organisations

2 - Appropriate - reasonable
- consistent with present requirements or standards
- consistent with available information
- Makes sense to an informed lay person
3 - Just and fair - see by an impartial body
4 - Transparent and defensible - peer review and court of law

Evidence base

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3
Q

Benefits of EBM

A

Flexibility - keeps pilots in the air more often
Defensible - stands up to legal scrutiny
Fair and consistent - can’t hide behind “the rules”
Transparent. - pilots understand it
Ability reshape policy and regulation

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4
Q

Difficulties with EBM

A
Time consuming and complex
Costly
Access to articles
Critical analysis difficult
Evidence rarely specific to the case
Diagnoses not always certain
Evidence may be poor or conflicting
Evidence may be misinterpreted
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5
Q

What is the difference between hazard and risk

A

Hazard - a source of potential harm or a situation with a potential to cause loss

Risk: the changes of something happening that will have impact upon objectives.
It is measure in terms of consequence and likelihood.

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6
Q

Describer of risk are likelihood and consequence. What are difference between likelihood and consequence

A

Likelihood: used as a qualitative description of probability or frequency

Consequence: the outcome of an event expressed qualitatively or quantitatively, being a loss, injury, disadvantage or gain. There may be a range of possible outcomes assoicated with an event

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7
Q

What is the 1% Rule

A

Acceptable risk of threshold
Should be <1% per year risk of sudden incapacitation deemed acceptable.
Assumes all - cause fatal accident rate of 1 per 10^7 flying hours
Same as risk of sudden catastrophic failure of airframe.

Based on

  • Civilian incident data
  • commercial air transport ops
  • two pilots
  • 10% of flight time “critical”

Establish Context in the risk management overview

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8
Q

Risk management overview

A
Establish context
Identify risk
Analysis risk
Evaluate risk
Treat risk

At anytime

  • monitor and review
  • communicate and consult
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9
Q

What are the 2 key questions to ask when identify risks

A

Does the medical condition impact upon flying safety or operational effectiveness?
- based on diagnosis, clinical history, prognosis, specialist report and medical evidence

Will the aviation environment affect the medical condition or its treatment?
- Based on known aviation-related risk factors.

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10
Q

Environmental stress checklist - consider when reviewing every patient

A
Altitude: hypoxia, pressure change
Acceleration
Motion sickness
Disorientation
Vibration
Noise 
Thermal stress
Smoke/fumes
Escape/survival
Fatigue
Time zone shifts
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11
Q

When analysising risk what these should be considered

A

Likelihood of event occurring

Consequences if outcome occurs

Use the Australian/New Zealand standard for risk management

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12
Q

Approach to treating risk

A

Manage likelihood

  • definitive intervention
  • definitive intervention + ongoing meds + control
  • Ongoing meds + control
  • Time + control
  • Time

Manage consequences

  • safety pilot, no pax
  • Safety pilot at all times
  • solo, airspace restrictions
  • restraints
  • solo, no airspace restrictions
  • as or with co pilot, pax
  • single pilot, pax
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13
Q

A fundamental approach to aeromedical pt

A

Practice good medicine - treat

Are they fit to fly now?
- is there a risk of incapacitation? Do I need to impose TMUFF?

Manage the case
- IX and refer in order to making diagnosis and guide treatment. Diagnose and treat

Consider long term disposition
- Consider MECR, compile documents and consult as needed.

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14
Q

Other factors affecting decisions

A
Patient ADF experience
Role in the aircraft, pilot vs non pilot
Future career aspirations
Single vs multi-crew
Postings
Flying pay
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15
Q

An example of risk managing “aeromedical consequence” could be
A. Controlling symptoms with medication
B. Performing coronary angioplasty
C. Applying an operational multi-crew restriction
D. Monitoring thyroid function

A

C applying an operational multi-crew restriction

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